Richard A Kasufkin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036103195 Issued in IL

Practice address

7230 W North Ave Ste 106B
Resurrection Immediate Care Center
Elmwood Park, IL 60707-4262

Phone

(708) 453-3000

Fax

(708) 453-4660

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Suburban Hospital Medical Center

  • Skilled Nursing Facility
  • Oak Park, IL
  • NPI 1538206974
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1225068240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7230 W NORTH AVE STE 106B",
            "address_2": "RESURRECTION IMMEDIATE CARE CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607074262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 W NORTH AVE STE 106B",
            "address_2": "RESURRECTION IMMEDIATE CARE CENTER",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074262",
            "telephone_number": "708-453-3000",
            "fax_number": "708-453-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASUFKIN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3633309286030501",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103195",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "1619414",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanna LLC
• Ashira Johnson, MD
• William Anthony Jordan, PHARMD
• Joseph G. Craig DDS., LTD
• Andrew John Jursik III, DMD
• Katarzyna Mencel M.D.S.C.
• Christine Kathure, APN
• Kathy Meyer DDS PC
• Cara Allison Kehoe
• Eunice Kim

• Family Medicine Physician in Elmwood Park, IL
• Providers in Elmwood Park, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.